Tubes for Ear Infections

Middle ear infections are a common childhood health problem and treated fairly easily. However, some children suffer from hearing loss due to repeated infections, or have persistent ear infections that don't adequately respond to treatment. For those children, tubes may be necessary. Approximately 2 million children in the United States every year have surgery to have tubes put in their ears.

Function

• The middle ear is found behind the eardrum, is filled with air, and allows sound to vibrate the tiny bones in the middle ear. The Eustachian tube connects the middle ear to the back of the nose and allows for the equalization of air pressure. Fluid can build up behind the eardrum, and bacteria or viral infections are possible.When infection occurs in the middle ear, hearing can be compromised and pressure and pain can result.

Identification

• Certain children are more likely to get ear infections. Those who attend group childcare, children between 6 months and 2 years of age, those exposed to tobacco smoke at home, and those who take a bottle to bed are especially at risk. Ear infections are suspected when a child tugs or rubs at the ears, when fever is present, behaves in fussy manner, has changes in sleep or appetite, and seems to be having hearing problems.

Benefits

• A specialist, typically an otolaryngologist,or ear/nose/throat doctor, will recommend ear tube surgery if a child has persistent ear infections and/or hearing loss. The surgery allows air to get to the middle ear, and fluid can flow out of the middle ear into the ear canal. Fluid is cleared from the middle ear improving hearing, and the surgery prevents future fluid build-up, and also the pressure and pain associated with infection is alleviated.

Process

• During the surgery, a tiny surgical opening is made in the eardrum and a small plastic spool-shaped tube is inserted into the opening. This procedure is performed under a general anesthesia. The procedure takes about 15 minutes and the patient is allowed home within a couple hours. Usually the child may return to school the next day. Normal activities are resumed as well, with the exception of keeping water out of the ears, which sometimes requires earplugs. No stitches or incisions are made. Usually the tubes fall out within a year or so. If they remain 2-3 years, surgery may be necessary to avoid debris from accumulating in the middle ear area, or to avoid the eardrum being perforated. Approximately 25 percent of children require tubes to be placed again due to infections returning after tubes fall out.

Risks

• There are some risks associated with surgery to place tubes in ears. Most are uncommon. The eardrum may thicken over time, affecting hearing, but this is rare. Pus may be discharged from the ear. The tube may become blocked with fluid build-up and infection may occur. Rarely, a tube may slip into the middle ear. Also rarely, the eardrum may become scarred resulting in slight hearing loss.